Provider Demographics
NPI:1841724762
Name:TAIBI, DANIELLE (OTR)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:TAIBI
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 BENNETTS FARM RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2230
Mailing Address - Country:US
Mailing Address - Phone:203-403-5264
Mailing Address - Fax:
Practice Address - Street 1:27 GOVERNOR ST
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4657
Practice Address - Country:US
Practice Address - Phone:203-438-7862
Practice Address - Fax:844-409-2349
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4091225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist